肺动脉支架治疗儿童肺动脉分支狭窄近中期右心功能随访研究  

Early and median term right ventricular function recovery after stent implantation in children with pulmonary branch stenosis

作　　者：石诗[1] 金梅[1] 丁文虹[1] 王霄芳[1] 郑可[1] 梁永梅[1] 肖燕燕[1] 焦萌[1] 顾燕[1] 王志远[1] 张雅慧[1] SHI Shi JIN Mei DING Wenhong WANG Xiaofang ZHENG Ke LIANG Yong- mei XIAO Yanyan JIAO Meng GU Yan WANG Zhiyuan ZHANG Yahui(Department of Pediatric Cardiolo- gy,Beijing Anzhen Hospital, Capital Medical University, Beifing Institute of Heart, Lung and Blood Vessel Disea- ses, Beijing 100029, China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所心儿科,100029

出　　处：《心肺血管病杂志》2017年第8期674-677,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:探讨应用支架在治疗肺动脉分支狭窄后对右心功能的改善效果。方法:7例患有复杂先天性心脏病外科术后残余肺动脉狭窄的患儿接受了经导管应用支架置入的介入治疗。年龄4~18岁,平均年龄8.7岁,体质量13~56kg,平均28.4kg。结果:法洛四联症(TOF)术后残留左肺动脉或右肺动脉狭窄者6例,矫正型大动脉转位(c TGA)1例,分别置入右肺动脉支架4例,左肺动脉支架3例。随访至1年:支架置入后,肺动脉狭窄处内径明显增加;狭窄处压差(ΔP)较术前明显降低;三尖瓣瓣环收缩位移明显增大,右心室TDI提示右心室收缩舒张功能均明显改善。术后患儿活动耐量增加,心功能分级提高。结论:肺动脉支架置入术目前已成为肺动脉分支狭窄理想治疗方法,可解除狭窄并显著改善右心功能。Objective： To explore the indication,Methods： and effect of using balloon expandable stent placement to treat residual branch pulmonary artery stenosis. Methods： Seven cases with residual branch pulmonary artery stenosis after therapy treatment of congenital heart disease underwent the balloon expandable stent placement. The age was 4 to 18 years（ 8. 7 ± 6. 3） years. The weight was 13 to 56kg（ 28. 4 ± 17. 3kg）.Results： Four cases received the implantation of Pul-stent in the right pulmonary artery respectively. And three cases the implantation of Pul-stent in the left pulmonary artery. Early follow up： The mean minimum diameter of left and right pulmonary arteries increased from（ 4. 1 ± 1. 0） mm to（ 10. 9 ± 2. 7） mm. The mean pressure gradient around the stenosis region decreased from（ 62. 0 ± 12. 0） mm Hg to（ 34. 9 ± 16. 8） mm Hg. Midterm follow up： The mean minimum diameter of the stenosis region increased remarkably. The mean pressure gradient around the stenosis region decreased remarkably. And the function of right ventricle has improved. After the surgery,the daily movement of patients increased obviously. Conclusion： After the implantation of Pul-stent in the branch pulmonary,the daily movement of patients increased obviously. And the function of right ventricle has improved. The balloon expandable stent placement is a great therapeuticmethod for the branch pulmonary artery stenosis.

关 键 词：肺动脉狭窄 支架 右心功能 

分 类 号：R54[医药卫生—心血管疾病]